Objective To investigate the value of MSCT and ultrasonography in the diagnosis of nodular goiter. Methods The CT and ultrasound data of 68 patients with nodular goiter in our hospital during the period of December ~2016 December 2014 were collected, and the results were compared with clinical pathological examination, and the sensitivity, specificity and accuracy of the two methods were evaluated. Results Among 68 patients, there were 19 cases of malignant nodules, included papillary carcinoma in 9 cases, follicular carcinoma in 6 cases, and medullary carcinoma in 5 cases. There were 49 cases of benign nodules and cystic fibrosis in the other 34 cases, and there were interstitial fibrosis in 10 cases, hemorrhage and infection in 5 cases. Clinical pathological diagnosis of 19 cases of malignant nodules, benign nodules in patients with ultrasound diagnosis of malignant in 12 cases, benign in 56 cases. MSCT diagnosis of malignant nodules in 20 cases,benign in 48 cases. The sensitivity of ultrasound diagnosis(84.65%), specificity(77.57%) and accuracy (82.35%) were better than MSCT with the sensitivity(75.55%), specificity(65.29%) and accuracy(70.58%), there was significant difference between the two diagnostic methods(P<0.05). Conclusion The sensitivity, specificity and accuracy of ultrasonic diagnosis of nodular goiter are superior to that of MSCT.